Provider Demographics
NPI:1235499757
Name:FRANCIS, DARLENE
Entity Type:Individual
Prefix:MS
First Name:DARLENE
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DARLENE
Other - Middle Name:
Other - Last Name:SHORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:373 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2707
Mailing Address - Country:US
Mailing Address - Phone:631-608-8523
Mailing Address - Fax:631-608-8527
Practice Address - Street 1:373 BROADWAY
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2707
Practice Address - Country:US
Practice Address - Phone:631-608-8523
Practice Address - Fax:631-608-8527
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24892164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse